Implementation and Impact of HAV and HBV Vaccination Programs in South America
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GLOBAL PERSPECTIVES: SOUTH AMERICA (MO SILVA, SECTION EDITOR)
Implementation and Impact of HAV and HBV Vaccination Programs in South America Raymundo Paraná & Maria Isabel Schinoni
Published online: 26 September 2013 # Springer Science+Business Media New York 2013
Abstract Viral hepatitis A and B virus are considered an important public health problem in most of South American countries. Its distribution and prevalence are highly heterogeneous all over the continent, depending on geographic, socioeconomic and cultural factors. The hepatitis A virus is transmitted through the oro-fecal route. Although it usually causes a self-limited disease, it is still responsible for some cases of fulminant hepatitis in children and adults. The universal vaccination program against hepatitis A in infants in some countries such as in Argentina, has brought significant reduction in cases of acute liver failure and liver transplantation. Hepatitis B virus (HBV) infection is transmitted through percutaneous and mucosal exposure to infective body fluids. Sexual transmission seems to prevail in most countries, but vertical and horizontal transmission in the early life predominates in highly endemic areas, such as the Amazonia. Around 20 % of HBV carriers in Amazonian are also infected with delta virus. Universal and high risk groups HBV immunization programs implemented in different countries drastically decreased HAV and HBV morbidity and mortality. However, the goal to eliminate both virus infections from this region has not been achieved yet. It is necessary to insure that the existent programs are sustained over time.
Introduction
Keywords Hepatitis A . Hepatitis B . Vaccination programs . South America
Hepatitis by A Virus (HAV)
R. Paraná (*) Gastro-Hepatology Unit of University Hospital of School of Medicine of Bahia Federal University, Avenida Juracy Magalhães Júnior, 2096.Sala 510, Rio Vermelho, Salvador, Bahia, Brazil CEP40110-060 e-mail: [email protected] M. I. Schinoni Gastro-Hepatology Unit of University Hospital of School of Medicine of Bahia Federal University, Av. Princesa Isabel 86 Ap. 1701, Barra Avenida, Salvador CE 40140000, Brazil
It is estimated that there are currently 350,000 million people carriers of hepatitis B virus (HBV). The HBV is responsible for 500,00 to 700,000 related deaths due to cirrhosis, hepatocellular carcinoma and acute and fulminant hepatitis. Hepatitis A virus infects approximately 1,400,000 million people worldwide, with the viral infection being almost universal before 10 years of age in highly endemic regions. Although it commonly induces mild and self limited acute hepatitis, when happening in low endemic regions it can be responsible for many cases of severe acute hepatitis and liver failure [1, 2]. Viral hepatitis A and B are currently preventable diseases through very effective immunization vaccines. The current scenario in South American countries, where cultural and socioeconomic factors contribute to the spread of these viral diseases, vaccination against HBV and HAV are still fa
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